| NPI | 1679533509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301035488) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI JG035488) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-07-25 |